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Genome-wide meta-analysis identifies genetic risk factors and implicates multiple body systems in panic attacks and disorder

Mitchell, B. L.; Skelton, M.; Wang, R.; ter Kuile, A. R.; Murphy, A. E.; Morneau-Vaillancourt, G.; Li, D.; Assary, E.; Hotopf, M.; Hu, J.; Armour, C.; McIntosh, A. M.; Walters, J. T. R.; Lyall, D. M.; Smith, D. J.; Lifelines Cohort Study, ; NIHR BioResource Consortium, ; Kingston, N.; Bradley, J. R.; GLAD Study Authors, ; Kalsi, G.; Lee, S.-H.; Lin, Y.; Vassos, E.; Kakar, S.; Meldrum, L.; Smith, I.; Ventura, G. C.; Olsen, C. M.; Whiteman, D. C.; Medland, S. E.; Lind, P. A.; Byrne, E. M.; Hickie, I. B.; Wray, N. R.; Mach, L.; Noseda, M.; Forstner, A. J.; Snieder, H.; Hartman, C. A.; Martin,

2025-06-16 genetic and genomic medicine
10.1101/2025.06.15.25329656 medRxiv
Show abstract

Introductory paragraphPanic attacks, sudden episodes of intense fear accompanied by physical and psychological symptoms, affect approximately 23% of the population1,2. Panic disorder, diagnosed in 2- 4%3, involves recurrent attacks followed by persistent worry about further attacks, leading to functional impairment and avoidance behaviours1,2. We conducted genome-wide association meta-analyses of panic attacks and panic disorder (61,746 and 29,775 cases, respectively, and 105,814 controls), identifying the first genome-wide significant variants for both traits (16 for panic attacks; 7 for panic disorder). Geneset analysis using single-cell RNA sequencing data implicated afferent neurons from the eye, heart, and lung in panic attacks, suggesting a critical role for sensory processing and interoceptive awareness. Further analyses suggested that these associations generalize to other psychiatric disorders. These findings offer novel insights into the biological mechanisms underlying panic, the role of afferent neurons, and may inform the development of more targeted and effective interventions.

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